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CPA CLINICAL SPECIALTY PROGRAM

Candidate Documentation
Date Submitted:

Candidate ID:

CPA Clinical Specialty Program


Candidate Documentation

Canadian Physiotherapy Association

Page 1 of 8

CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Candidate ID:

Date Submitted:

INSTRUCTIONS
1. Enter your Candidate ID and submission date in the header of this document.
2. Reflect on and summarize your experience and development as a clinical specialist. When selecting
documentation to include in your portfolio consider the relevance of the information to the
physiotherapist specialty designation.
3. Use the templates below to record examples for each requirement giving consideration to its
application to your development as a clinical specialist.
4. It is suggested this document be 10-15 pages in length when complete.

Canadian Physiotherapy Association

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Date Submitted:

Candidate ID:

Requirement 1:
Advanced Clinical Competence in the Clinical Specialty Area
The clinical specialist in physiotherapy has developed advanced clinical competence through applied
clinical experience in the clinical specialty area. Clinical competence is assessed directly and indirectly
throughout the various components of the submission (Clinical Reflections, Multi-Source Feedback
responses, Case Based Discussion and documentation).
Clinical Hours
Number of Years Practicing as a Physiotherapist:
Number of Years Practicing in Specialty Area:

Education
Name of Institution

Degree Obtained

Location

Year
Obtained

Clinical Experience
Name of Employer

Responsibilities/Areas of
Practice

Canadian Physiotherapy Association

Location

Dates

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Date Submitted:

Candidate ID:

Requirement 2:
Professional Leadership in the Clinical Specialty
The clinical specialist in physiotherapy demonstrates commitment to the profession, health care and
society by engaging in strategic leadership that promotes best practice. Leadership activities may include
teaching, mentorship, volunteer association work, public/community education and other.
2.1

Record all relevant professional development courses/workshops you have taught in your clinical
specialty area (note: activities related to students will be noted in section 2.4). Select and include
supporting documentation where appropriate:
Date

2.2

Course Name

Location

# of
times
course
was
taught

Record all relevant presentations given in your clinical specialty area, including those given to both
professional and public audiences:
Date

2.3

Name of PostSecondary
Institution/Organization

Title

Location

Audience

Record your key mentoring experiences (within or outside of the physiotherapy profession).
Dates
(indicate
length of
time)

Mentee

Canadian Physiotherapy Association

Description of Mentoring Experience

Location

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Date Submitted:

Candidate ID:
2.4

Record your key teaching experiences (e.g. clinical placement supervision, lectures for physiotherapy
students or other disciplines)
Date

Description of Teaching Experience

Location

Audience/Student

2.5

Describe how your teaching experiences have influenced your development as a clinical specialist.

2.6

Record associations, organizations, and committees with which you have participated:
Date

2.7

Title (i.e. Chair,


President, Member,
etc)

Responsibilities

Record any honours/awards you have received since entry to practice:


Year

2.8

Organization

Award Name

Award Donor

Describe how your professional leadership experiences have influenced your development as a clinical
specialist.

Canadian Physiotherapy Association

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Candidate ID:

Canadian Physiotherapy Association

Date Submitted:

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Date Submitted:

Candidate ID:

Requirement 3: Continuing Professional Development


The clinical specialist in physiotherapy is involved in continuing professional development. Successful
fulfillment of this requirement may be achieved by completing a range of academic and clinical courses or
clinical practicum, clinical supervision of students, or experience in an academic environment. Provide
copies of certificates for programs including an evaluation component.
3.1

Record the continuing professional development courses that you feel were most important to your
development as a clinical specialist. Highlight the 5 key courses with an asterisk (*):
Course Date
(mm/yy)

3.2

Location

Instructor

Record workshops, scientific conferences, congresses, symposia you attended that contributed to your
development as a clinical specialist:
Date
(mm/yy)

3.3

Course Title (include brief description)

Professional Development Activities Attended (other than


courses)

Location

Describe how these learning experiences have influenced your development as a clinical specialist.

Canadian Physiotherapy Association

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CPA CLINICAL SPECIALTY PROGRAM


Candidate Documentation
Candidate ID:

Date Submitted:

Requirement 4: Involvement in Research


Candidates are required to demonstrate the integration of research and research findings within their
clinical practice. Candidates may demonstrate proficiency in the competencies through various research
activities to advance physiotherapy practice.
Activities may include, but are not limited to, the integration of research tools (e.g. outcome measures,
systematic reviews, surveys, clinical practice guidelines) into clinical practice, involvement in a research
study or program evaluation, documentation of a single case study, dissemination of research findings
and the promotion of best practice principles within or outside the candidates own practice.
4.1

Describe your involvement in research activities relevant to your clinical practice and your development
as a clinical specialist. Provide relevant documentation.

4.2

Describe how your research involvement has contributed to your development as a clinical specialist.

Additional Information
5.1

Provide any additional information regarding your professional activities that you believe should be
considered in this application.

Canadian Physiotherapy Association

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